How to Minimize Hair Loss During Chemotherapy

Lead writer: Wendy Korn

April 27, 2012

Depending on the type and dosage of chemo you receive, you may experience hair thinning and even baldness.(GETTY IMAGES)Once you've committed to treating your breast cancer with chemotherapy, there's a good chance you'll lose at least some of your hair. Side effects range from thinning to total baldness and depend mostly on the type and dosage of chemo you receive. The problem isn't limited to the hair on your head—you may lose your body or pubic hair too. The loss is usually temporary, but it's one of the side effects that women fear most. Fortunately, there are some steps you can take to minimize it.

Hair-loss therapiesSeveral treatments have been researched as ways to minimize hair loss or speed regrowth, but none of them are 100% effective. Hair-restoration "experts" and products may make big promises; as a general rule, if it sounds too good to be true, it probably is.

You and your doctor may disagree about whether you should try one of these products. "Doctors tend to put little faith in hair-saving measures with questionable outcomes, but that doesn't mean there are not options out there that patients can try," advises Mario Lacouture, MD, director of the Robert H. Lurie Comprehensive Cancer Center's Dermatologic Care Center at Northwestern University in Chicago.

Minoxidil (Rogaine)Applying Rogaine directly to your scalp won't entirely prevent hair loss, but it's been shown to speed hair regrowth in breast cancer patients who have lost their hair, and it may even delay the loss. A small 1996 study found that while minoxidil did not prevent hair loss in women undergoing chemotherapy for breast cancer, it took longer for hair to fall out, and hair eventually grew back faster.

It isnt cheap, however, and it can cause scalp irritation or itchiness. If you have heart disease, talk to your doctor before using Rogaine, as it may cause rapid heart rate or low blood pressure.

Scalp hypothermiaDepending on the type of chemo you're receiving, wearing a frozen gel cap or ice pack during treatment may help reduce hair loss. By chilling the scalp during intravenous chemo, blood flow to hair follicles is reduced. This, in turn, reduces the amount of the chemo drug absorbed by the follicles, which minimizes follicle damage and potential hair loss.

The process can be cold and uncomfortable, but analyses of several studies have found that the potential benefit of preventing hair loss may outweigh the downside. One small, oft-cited study of breast cancer patients taking doxorubicin (Adriamycin) suggests that scalp cooling can make a significant difference. Of the 28 participants who successfully wore a frozen gel cap during the administration of the chemotherapy drug, 12 had no substantial hair loss, while 10 showed only minor loss. Six women lost most or all of their hair, despite the scalp cooling.

There's also a potential danger with scalp hypothermia. Since the procedure reduces the dose of chemotherapy that reaches the scalp, it carries a slight risk of metastases in that area.